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CaRdiac Arrest Survival Score (CRASS) – A tool to predict good neurological outcome after out-of-hospital cardiac arrest

Resuscitation Nov 19, 2019

Seewald S, Wnent J, Lefering R, et al. - A score to predict the outcome for patients brought to hospital following OHCA was developed and validated in this work. From the German Resuscitation Registry (2010-2017), researchers assessed patients who suffered OHCA, who had ROSC or ongoing CPR at hospital admission and divided them into development (2010-2016: 7,985) and validation dataset (2017: 1,806). Variables identified to have a significant positive (+) or negative (-) impact were: age 61-70 years (-0·5), 71-80 (-0·9), 81-90 (-1·3) and > = 91 (-2·3); initial PEA (-0·9) and asystole (-1·4); presumable trauma (-1·1); mechanical CPR (-0·3); application of adrenalin >0-<2 mg (-1·1), 2-<4 mg (-1·6), 4-<6 mg (-2·1), 6-<8 mg (-2·5) and > = 8 mg (-2·8); pre emergency status without previous disease (+0·5) or minor disease (+0·2); location at nursing home (-0·6), working place/school (+0·7), doctor’s office (+0·7) and public place (+0·3); application of amiodarone (+0·4); hospital admission with ongoing CPR (-1·9) or normotension (+0·4); witnessed arrest (+0·6); time from collapse until start CPR 2-<10 min (-0·3) and > = 10 min (-0·5); duration of CPR <5 min (+0·6). The AUC in the development dataset was 0·88 (95% CI 0·87–0·89) and in the validation dataset 0·88 (95% CI 0·86–0·90). The development dataset and the validation dataset exhibited AUC of 0·88 (95% CI 0·87–0·89) and 0·88 (95% CI 0·87–0·89), respectively. These findings suggest that for patients brought to the hospital following OHCA, the CaRdiac Arrest Survival Score (CRASS) may aid in calculating the probability of survival with good neurological function.
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